Objective To investigate the risk factors and their prevention and treatment approaches for occurring radial artery spasm (RAS) during the brain digital subtraction angiography (DSA) with transradial catheterization in patients with ischemic cerebrovascular disease.Methods The patients who underwent DSA of transradial approach because of ischemic cerebrovascular disease were enrolled.Their clinical data,surgical complications,and radial artery spasm were collected.The data of occurring RAS or not during DSA of transradial approach in patients were compared.Multivariate logistic regression analysis was used to analyze the risk factors for occurring RAS during DSA of transradial approach.Results A total of 100 patients with ischemic cerebrovascular disease who underwent DSA of transradial approach (74 ischemic stroke,26 transient ischemic attack) were enrolled,of which 21 (21％) had RAS.Of the 21 patients with RAS,4 suspended their operations and completed their DSA after spasm relief; another 17 were treated with intrathecal cocktail (heparin 2500 U,nitroglycerin 0.5 mg,verapamil 1.25 mg) and completed their DSA after spasm relief.There were significant differences in the proportions of radial artery diameter (1.89 ±0.28 mm vs.2.12 ± 0.17 mm; t =1.582,P =0.041),duration of operation (12.3 ± 3.1 min vs.9.8 ±2.7 min; t =1.264,P =0.038),and radial artery diameter ＞2 mm (9.52％ vs.65.82％ ;x2 =9.624,P =0.002),radial artery anatomy variation (23.81％ vs.0.27％; x2 =14.185,P＜ 0.001),and the first successful puncture (42.86％ vs.78.48 ％ ;x2 =5.335,P =0.021) in patients between RAS group and the non-RAS group.Multivariate logistic regression analysis showed that the radial artery anatomy variation (odds ratio [OR] 1.940,95 ％ confidence interval [CI] 1.372-2.241; P=0.023) was an independent risk factor for the occurrence of RAS.Radial artery diameter ＞2 mm (OR 0.752,95％ CI 0.352-0.847;P=0.043) and the first successful puncture (OR 0.843,95％ CI 0.367-0.941; P=0.045) were the independent protective factors for RAS.Conclusions RAS is a common complication of DSA of transradial approach.Repeated puncture,radial artery diameter,and radial artery anatomy variation are its most important influencing factors.

Objective:To investigate ?-catenin expression during check pouch carcinogenesis in golden hamster.Methods:Expression of ?-catenin was examined with immunohistochemical SABC method in 23 cases of check normal buccal epithelium of golden hamster,22 of hyperplasitic epithelium,22 of dysplastic epithelium,29 of squamous cell carcinoma.Results:Normal buccal epithelium showed strong pericellular staining in the basal,suprabasal and prickle cell layers.Positive rates(%) of ?-catenin in normal buccal epithelium,hyperplastic epithelium,dysplastic epithelium and squamous cell carcinoma were 100,100,77.3 and 41.4 respectively.Conclusion: The decreased expression of ?-catenin may be related to the carcinogenesis of golden hamster check pouch.

Objective To explore the influence of combination of Chinese traditional and western medicine continuing nursing care on treatment outcome and quality of life of patients with chronic urticaria.Methods 96 confirmed chronic urticaria patients were selected and divided into the control group and the observation group with 48 patients in each group according to random digit table.The control group was given with routine nursing mode.The observation group received combination of Chinese traditional and western medicine continuing nursing care.The treatment lasted for 12 months.Treatment effect and Dermatology Life Qudity Index (DLQI) evaluation were executed at the end of the 3rd,6th and 12th months.The relapse was inquired 2 months after the intervention by follow-up.Results The total effective rates in the control group and the observation group at the end of the 3rd,6th and 12th months were 75.6％ (34/45),80.0％ (36/45),82.2％ (37/45) and 87.0％ (40/46),91.3％ (42/46),93.5％ (43/46),the results showed significant difference,P ＜ 0.05.DLQI scores at the end of the 3rd,6th and 12th months in the control group and the observation group were (7.82±1.95),(7.04±1.58),(6.56±0.88) scores and (6.85±1.56),(5.71±1.03),(3.42±0.78) scores,the differences were significant,P＜0.05.The relapse interval time was (24.75±5.07) days and (38.20±7.22) days,the difference was statistically significant (P＜0.01).Conclusions Combination of Chinese traditional and western medicine continuing nursing care can significantly improve treatment outcome of chronic urticaria,reduce relapse rate,increase quality of life for patients with chronic urticaria,and it is better than routine nursing care and is worthy of being popularized.

Objective To investigate effects of arthroscopic reconstruction of medial patellofemoral ligament (MPFL) using partial peroneus longus tendon autograft in treating recurrent patellar dislocation.Methods Forty-six patients (53 knees) with recurrent dislocation of patella received autologous partial peroneus longus tendon grafting for MPFL reconstruction after arthroscopic lateral retinaculum release from May 2009 to April 2010.Anatomic relation between femoral trochlea and patella,and motion path of patella were observed arthroscopically in adjustment of flexion and extension strength of grafted tendon in different angles.Successively,the tendon ends were fixed within bone tunnel of medial femoral condyle by using absorbable interface screws with synchronous superomedial displacement of tibial tuberosity.Stability of patellofemoral joint,dislocation recurrence,subjective symptoms of affected knees and general function recovery condition of affected limbs were studied.Results All patients were followed up for average 18 months (range,12-24 months),which showed the improvement of knee joint stability,without recurrence of patellar dislocation.Apprehensive test was negative.Axial X-ray films and CT of patella showed normal anatomical relation of patellofemoral joint.The Kujala patellar stability questionnaire scored (54.6 ±5.4) points before operation and (92.3 ±8.9) points after operation (t =55.41,P ＜ 0.01).All patients showed some improvement of motor ability after operation.CT examination showed that the congruence angle of patella and femoral trochlea was improved from preoperative (27.8 ± 8.1) ° to postoperative (2.3 ± 9.4) ° (t =20.87,P ＜ 0.01).Otherwise,ankle joint in the tendon donor site acted well,with normal function.Conclusion Arthroscopic lateral patellar retinaculum release and MPFL reconstruction using partialperoneus longus tendon autograft are effective in treatment of recurrent patellar dislocation in combination with superomedial displacement of tibial tuberosity,and avoid potential complications in tendon removal from around knee joint.

A total of 35 patients with hallus valgus (56 feet) received treatment at the Department of Orthopedics, the Sixth People's Hospital, Shanghai Jiao Tong University between January 2004 and June 2005 and were recruited into this study. These patients underwent osteotomy of proximal first metatarsal and internal fixation with poly (L-lactic acid) (PLLA) absorbable pins. All patients were followed up for 4-22 months. Excellent outcomes were found in 27 patients (44 feet) and good results in 8 patients (12 feet). The mean healing time of surgical region was 6 weeks, nonunion or delayed union was not found. There were 3 cases suffering from complications post surgery. Two of them presented with peripheral wound red swelling, considering as a result of extraneous material-caused aseptic inflammatory reaction. This phenomenon would be regressed 2-4 weeks after hydropathic compress of ethanol gauzes and timely renewal of dressings. There was 1 case who suffered from protrution of absorbable pin 1 week after fixation and received reposition and plaster fixation. Bone displacement and nonunion were not found. This complication maybe results from excessively large bone pore due to shaking of electrodrill, which leads to loosening of absorbable pins.

Objective To investigate the clinical effect of the blood transfusion with equal ratio component in severe multiple in‐juries with acute traumatic coagulopathy(ATC) .Methods Thirty‐eight patients who had severe multiple injuries with ATC were divided randomly into control group and treatment group .Control group was treated with the different ratio packed red blood cells (PRBC)and fresh frozen plasma(FFP) ,while treatment group received the equal ratio PRBC and FFP .Hemoglobin(HB) ,pro‐thrombin time(PT) ,international normalized ratio(INR) ,fibrinogen(FIB)were measured on the 1st ,2nd ,3rd day after admission . The total amount of PRBC during these 3 days ,the days of hospitalization in ICU ,the corrected rate of shock ,the 28‐day mortality were compared between groups .Results Compared with the control group ,the levels of PT ,INR and FIB of treatment group on the 2nd ,3rd day after admission were better(P<0 .05) .The total amount of PRBC[(18 .5 ± 6 .3)U]during these 3 days ,the days of hospitalization in ICU [(5 .9 ± 4 .3)d] in treatment group were less than those in the control group [(25 .9 ± 7 .8)U ,(10 .5 ± 7 .6)d] (P<0 .05) ,while the corrected rate of shock(85 .0% )in treatment group was higher than that of the control group(44 .4% ) .The 28‐day mortality(10 .0% )in treatment group was lower than that of the control group(27 .8% )(P<0 .05) .Conclusion The blood transfusion with equal ratio component in severe multiple injuries with ATC could not only improve blood clotting index ,reduce the total amount of PRBC and the time in ICU ,but also increase the corrected rate of shock and decrease the 28‐day mortality .

Objective To investigate the risk distribution of breast cancer for location and time of recurrence metastasis in molecular subtype.Methods We studied retrospectively the female patients who were diagnosed as invasive ductal breast cancer in our hospital from July 2004 to June 2012,detected ER,PR,and HER2 expressions in the paraffin sections.The patients with recurrence metastasis were divided into local recurrence and distant metastasis with the first transfer site as standard for analyzing the distribution in molecular subtype and the time of the first site of recurrence metastasis.Results Sixty two patients were encountered recurrence metastasis,including 23 patients with local recurrence,and 39 patients with distant metastasis,death 11.The rates of distant metastasis for patients who belonged to HER2 type and basal-like type were higher than that of local recurrence (P =0.01,P =0.001).The risk distribution of recurrence metastasis time in molecular recurrence metastasis showed that 35 percent of recurrence metastasis time of luminal A type was first 3 years,75 percent of molecular subtype of basa1-1ike type recurrence metastasis time in first 3 years and advanced.The peak of luminal B and HER2 type was first 3 years,and very low in 5 years.Conclusions Molecular subtype of breast cancer is an important complement for TNM method in accurately assessing the patients of recurrence metastasis for location and time,and is helpful for the individual screening of patients for recurrence metastasis.

BACKGROUND: It is important to study the methods of culturing bone marrow-derived mesenchymal stem cells (MSCs) to obtain a great amount of high purity MSCs for applying ocular tissues constructed by tissue engineering technique to treat eye diseases.OBJECTTVE: To separate and culture in vitro MSCs from bone marrow of the adult rats by density gradient centrifugation combined with adherence culture, and observe the growing characteristics and the possibility of mass multiplication.DESIGN: A completely randomized grouping design/repetitive measuring experiment.SETTING: Pathological laboratory, Zhongshan Ophthalmic Center, Sun Yat-sen University.MATERIALS: Four six-week-old SD rats about 250 g, grade Ⅱ of cleaning, were provided by the Animal Center of Sun Yat-sen University [certificate number: SCSK(Yue)2004/0011], about 250 g each rat and there was no limit to the sex. The main reagents and instruments included low sugar Dulbecco modified Eagle culture medium (DMEM/F12, American Gibco Corporation), trypsin (fetal bovine serum (FBS, Hangzhou Sijiqing Bio-Engineering Material Research Institute), American Gibco Corporation), disodium edetate, lymphocyte separating medium, fibronectin, CD44, CD34, CD31 monoclonal antibodies, two-step-method kit for immunohistochemistry (Beijing Zhong shan Biotechnology Corporation).METHODS: This experiment was conducted at the Key laboratory of Ophthalmology (Sun Yat-sen University), Ministry of ethanol (750 g/L) for 10 minutes. Under aseptic condition, the medullaris cavitas was exposed, the syringe containing application m edium was directly punctured into the femoral cavity, the cells in the medullaris cavitas were washed out with the culture medium containing heparin and taken as the cell suspension. The bone marrow-derived MSCs were separated and purified by density gradient centrifugation combined with adherence culture, and the growing conditions of the wells. When the cells had generally connected with each other, they were fixed with methanol or dimethy ketone in situ for 10 minutes, and then hematoxylin eosin (HE) staining or immunohistochemical staining. Antibodies against fiinoculated to 96-well culture plate by a cell density of 4.25×107/L, with 200 μL every well; then put the culture plate into culture box. Then from the next day to the sixth day, 5 g/L MTT solution was added into two rows (20 μL every well) every day, continuously cultured for 4 hours, then the supernatant was removed, and 200 μL DMSO was added to each well, agitated for 5 minutes, then detected the absorbance (A) values at 570 nm wave length, and a growth curve was drawn.branes were clear and the cell bodies were lucent. Being cultured for 2 days, there appeared adherent cells. 3 days later,most of the adherent cells extended and appeared to be in polygon, star or long-shuttle shapes. 4 days later, the cells showed to be in division growth stage; and about 12 days later, the cell clones were connected to each other, appearing curve of subcultured MSCs was in S shape. Cells began growing fast on the 2nd day after being passaged, and they entered the growth period for 3-4 days followed by saturation period, and then cells stopped growing.CONCLUSION: It is a simple and practical method to separate MSCs from the bone marrow of adult rats by means of density gradient centrifugation and adherence. MSCs can greatly proliferate in vitro and offer seed cells for the application of tissue engineering technique to treat eye diseases.

Objective: To discuss the way of early nutritional support in the patients after the liver transplantation. Methods: The nutritional support was used in 28 patients who had suffered the orthopetic liver transplantation (OLT).Parenteral nutrition was started as soon as possible after the operation. On the fourth day after the operation, enteral nutrition was also used. Results: 5 patients died from the postoperative complications. 23 patients survived and had been in better nutrition. Conclusion: The early nutrition support can play an important role in the patients recovery after OLT. EN should be administrated immediately when the gut functions.

Objective To study the expression of fragile histidine triad(FHIT) in oral squamous cell carcinoma(OSCC),and discuss its role and significance in OSCC.Methods Immunohistochemical method was used to detect the expressions of FHIT in 48 cases of OSCC and 26 normal oral mucosa.Results The positive expression rate of FHIT in normal oral mucosa was 76.92%(20/26).Among 48 OSCC patients,the positive rate of FHIT(43.75%) was lower than that in normal oral mucosa(P0.05),but FHIT protein content was significantly associated with differentiation(P